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  • Inkerbell
    Participant
    Post count: 2

    Dr Corenman,
    I am a 47 yr old female who started having back & neck issues in 2006. All I have ever done over the years is see a chiropractor. It’s been almost 2 years now when I finally got decent insurance and was able to have a PCP refer me to a specialist. He wanted to start with my neck issues first. I had a faucet injection Aug 2015 (then I lost my health insurance) and the injection has since worn off. However I now have a new PCP who is also a sports medicine Dr. Prior to getting my insurance back, I have been having excruciating lower back pain and sciatic issues. For the last 9 months the pain get’s so bad that it makes me nauseous. The pain is in my hips, buttocks, thigh, calf, foot, arch and toes. It is affects my job (In home care for seniors). I cannot sit, stand, drive, clean, or lay down for any length of time. I am constantly hurting. Sometimes my leg muscles cramp up and remain that way for 48 hours or so. I have been on several different pain medicines and muscle relaxers prior to my neck injection and nothing helps.I also had done physical therapy in the past. I have also told the Dr that I feel very depressed, I am so tired of hurting, and I feel like this is the cause of my back and forth constipation and diarrhea as well. Most of the time I dont even have an appetite due to the pain. I also went and bought an elevation table and tried that for about 3 months to no avail of any relief. This new Dr has refereed me to a pain management Dr who only gives injections, no RX’s. But I don’t see him until the end of June. And I don’t think I am interested in any back injections, and I’m contemplating even getting another neck injection. I feel strongly these just mask the issues at hand and in the meantime things just get more damaged. I am still young and I used to be very very active, however I have lost interest in everything becasue I constantly hurt. My Dr sent me for an MRI, and this was the findings. I dont have my next appointment until the middle of May and now I am wondering if I should call and see him sooner. If the MRI has significant findings that are serious I would think his office would call me, however I want to make sure I don’t get lost in the shuffle of his very busy schedule and office.
    Any insight would be very much appreciated.

    CLINICAL INDICATION: chronic back pain
    COMPARISON: None.
    TECHNIQUE: MRI of the lumbar spine was obtained with the following
    sequences: Sagittal T1-weighted, STIR and T2-weighted. Axial T1
    and T2-weighted.

    FINDINGS:
    Osseous and Disc Structures: No acute fracture. Mild grade 1
    anterolisthesis of L4 on L5. Mild grade 1 retrolisthesis of L5 on
    S1.

    Moderate disc space narrowing at L5-S1. Mild disc space narrowing
    at L4-L5. Mild disc desiccation changes at L1-L2 to L5-S1 levels.

    Spinal Canal: The conus medullaris is normal in position at mid
    L1 level.

    Paraspinal Soft Tissues: Visualized portions within normal
    limits.

    Findings at individual levels are as follows:

    T12-L1: No significant disc protrusion, spinal canal stenosis or
    neuroforaminal narrowing.

    L1-2: Trace disc bulge. No spinal canal stenosis or
    neuroforaminal narrowing.

    L2-3: Trace disc bulge. No spinal canal stenosis or
    neuroforaminal narrowing.

    L3-4: Trace disc bulge. No spinal canal stenosis no significant
    neuroforaminal narrowing.

    L4-5: Grade 1 anterolisthesis due to severe bilateral facet
    arthropathy. Disc bulge with a broad disc ossific complex. There
    is narrowing of the right lateral recess with impingement of the
    descending L5 nerve and mild spinal canal stenosis. Mild to
    moderate bilateral neuroforaminal

    L5-S1: Mild grade 1 retrolisthesis. Concentric disc bulge and
    left paracentral disc protrusion dorsally displacing the
    descending left S1 nerve which is likely impinged. Mild to
    moderate bilateral neuroforaminal narrowing.

    IMPRESSION:
    Grade 1 anterolisthesis of L4 on L5. Grade 1 retrolisthesis of L5
    on S1.

    Mild spinal canal stenosis and right lateral recess narrowing at
    L4-L5 impinging the descending right L5 nerve.

    Dorsal displacement and impingement of the left S1 nerve in the
    lateral recess at L5-S1.

    Mild to moderate bilateral neuroforaminal narrowing at L3-4 to L5
    and L5-S1.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You have good reason to have back and leg pain. You do not however identify which leg is involved (or is it both legs).

    You have a lumbar degenerative spondylolisthesis with right lateral recess stenosis compressing the right L5 nerve root. You also have a lumbar disc hernation compressing the left S1 nerve root. See those sections on this website to understand these disorders and how they cause pain.

    Injections might be helpful so don’t discount them. However, if you have motor weakness, you might have to see a surgeon. See the section on home testing at https://neckandback.com/conditions/home-testing-for-leg-weakness/.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Inkerbell
    Participant
    Post count: 2

    Dr. Corenman,

    Thank you for your reply back. My apologies, I did leave out which leg, I didn’t realize I did that. It’s my left side. And if I move certain ways I can feel bone on bone grinding.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    The left leg pain is most likely caused by your disc herniation at L5-S1 on the left. You need to discern the pain location of your lower back. Is it mostly left sided and lower (near the buttocks) or is it central (in the middle of your back)?

    The “bone on bone grinding” is most likely the degenerative facets of L4-5 making that impression. It is generally not dangerous and if not painful, can be ignored.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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